Endocrine Abstracts

Backround: The increased frequency of performing imaging investigations in the period following the SARS-COV-2 pandemic has led to more frequent identification of adrenal lesions in patients who subsequently required further endocrine evaluation.

Objective: To compare the functional profile of the newly diagnosed lesions vs those coming for follow up over 2023.

Methods: Retrospective observational study aiming all of the patients admitted in our endocrinology department for adrenal lesions evaluation within the 2023 year. Variables such as age, sex, chronic diseases (arterial hypertension, diabetes, dyslipidemia, obesity, osteoporosis), laboratory investigations (adrenal hormones: cortisol, aldosterone, metanephrines, normetanephrines), the results of imagistic investigations used to diagnose the adrenal lesion and the choices of treatment were collected from 160 patients’s medical records. Comparisons were made between the newly diagnosed patients (85) and those who had already previous evaluations (75).

Results: 160 patients were included with comprehensive evaluation for adrenal lesions in our department over the whole 2023 year: 85 newly diagnosed patients and 75 patients with previous evaluation (diagnosed between 2007-2022) with a majority of women (65/85, and 62/75 respectively), aged between 23 and 80 (mean age 58.8 y). The diagnostics were as follows : unilateral adenoma 53 out of 85 in new cases vs 51 out of 75 in ‘old’ cases (NS), bilateral adrenal hyperplasia (30/85 in new vs 24/75 in old cases group, NS) and two adrenal carcinomas (both cortisol-secreting, one of them also secreting androgens) only in the newly diagnosed cases. Functional profile was present in 24/85 in new cases vs 28/75 in old cases (P<0.05) as following: hypercortisolism 11 out of 24 functional lesions vs 10 out of 27 functional lesions in old cases, subclinical hypercortisolism 3/24 vs 2/27 cases, hyperaldosteronism 7/24 vs 9/27 cases, paraganglioma 5/24 vs 7/27 cases. Sixty of the 85 new cases and 51 of the 75 reevaluated patients were hypertensive. The most frequent management decision was periodic imagistic and hormonal reevaluation. Surgery was recommended in 10 of the new cases and 20 of the cases diagnosed between 2007-2022.

Conclusions: In the newly diagnosed group (over 2023), a functional profile was present in a smaller proportion than in those with previous evaluation. Among new patients, functional lesions were more frequent in men. Out of all 160 patients in the study, there was a correlation between secretor status and lesion distribution. More bilateral adrenal hyperplasias appear secretory than unilateral adenomas, but a larger sample is needed.